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BACKGROUND:
Recent studies have raised concerns regarding the usefulness of the visual analogue scale (VAS) as an effective outpatient patient-reported outcome measure (PROM), with disparate scores reported during the same encounter to a nurse versus physician. The purpose of present study was to assess the VAS reported by new patient referrals to 2 different physicians of varying training levels (resident, attending), during the same initial outpatient encounter.

METHODS:
One hundred and one patients treated by a single foot and ankle surgeon were included in the retrospective cohort. Each patient was asked to rate their pain intensity by a resident, and then by the attending surgeon using a standard horizontal VAS 0 to 10, from "no pain" to the "worst pain." Differences in reported scores were analyzed.

RESULTS:
Overall, the mean VAS reported to the residents (4.97 ± 2.75) and the attending surgeon (5.02 ± 2.71) were not significantly different ( P = .61). On the 11-point scale, the mean difference accounted for only 0.05 points.

CONCLUSION:
Taken into consideration with previous studies, the data suggest collection personnel may influence the reported VAS, possibly owing to patients' preferences and perception of their care. Although the exact reasons remain unclear, our findings lend credence to the previous concerns expressed regarding the subjective nature of the VAS.

Well, this looks interesting, not least because the conclusion they draw seems to be a direct contradiction of the result they report. I would love to read the whole thing to understand their reasoning but don't have access. Could anyone here provide us with a PDF? Thanks.

So now I have seen this - thank you to the kind member who sent me the PDF - and my suspicions are confirmed.

What's more, the self-contradiction is not the only error. The paper is all about the reliability of VAS - but the scale they used was not a VAS (i.e an unmarked 10cm line). Instead they used a numerical scale with the addition of emoticons and descriptive words.

I think this particular paper must have been published on April 1st! It is so blatant it must be a joke. Perhaps it was one of those scams put through deliberately to show up the weaknesses of the peer review system. It certainly succeeded.